Our Perspectives

An HIV milestone achieved in Cuba

In Cuba, preventive services, like HIV testing for all pregnant women, contributed to the elimination of mother-to-child HIV transmission. Photo: UNDP

This is a momentous moment for us working in Cuba.

The World Health Organization recently declared that Cuba had eliminated the transmission of HIV and syphilis from mother to child. Cuba is the first country to reach this goal and it is a great milestone for us. But it is also a landmark in the response to HIV globally.

How was Cuba able to achieve this?

Cuba’s comprehensive health system is available for all Cuban citizens equally, and is effective in integrating the health care of mothers and children with the health management of HIV and other sexually transmitted diseases. Because of this integration, Cuba has been able to strengthen its HIV and syphilis prevention efforts by offering early access to prenatal care, testing both pregnant women and their partners for HIV and syphilis (as a standard test that also includes other illnesses), treating women who test positive as well as their babies, and offering caesarean deliveries and alternative solutions to breast feeding, such as pediatric supplements.

These interventions are vital to preventing the transmission of HIV from mother to child. While an HIV positive woman has between a 15 – 45 percent chance of passing the virus to their child during labour, delivery or breast-feeding, the introduction of antiretroviral treatment greatly reduces the probability to just over 1 percent if taken by both the mother and her child during these high risk times. Because of Cuba’s comprehensive prevention programme, by 2013 only two babies were born with HIV and only five babies were born with congenital syphilis.

Cuba has had a comprehensive HIV prevention progamme for 15 years. Since 2003 UNDP, with support from the Global Fund to Fight AIDS, Tuberculosis and Malaria, has worked to strengthen this programme. We have trained community based health promoters through out the country and worked to ensure that all pregnant women are tested for HIV in their first prenatal consultation and receive treatment should they need it. We have rehabilitated the health infrastructure, including laboratories, surgery rooms, hospitals, and warehouses, and provided trucks and cold-chain cars to improve transportation of drugs and other supplies. We have purchased specialized equipment for HIV treatment and diagnostic work, diminishing testing times and improving follow-up and treatment quality.

But truthfully, none of Cuba’s gains would have been possible without the dedication and skills of the health sector workers and the mobilization of civil society in the communities. There is a huge team of Ministry of Health workers specifically dedicated to follow-up and supporting pregnant women, conducting a wide variety of activities, ranging from house visits to sophisticated genetic tests.

Cuba’s milestone can be seen as a beacon held up to the rest of the world. It can inspire us to believe that ending the HIV epidemic is possible, and simultaneously reminds us that there is still a lot more work to do. We must sustain the momentum generated by this news from Cuba and strengthen our efforts in other places to make sure that the elimination of HIV from mother to child is a milestone to be achieved around the world.